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15810 AMS y!"LICANT TO FILLAN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY c--� BU I LdING PROJECT I DENTIFICATION :PERMIT NUMBER But-c" APPLICATION & PERMIT N 158 O �' O noDREsOtt /� 21 QS Plan EA BUILDING -ELECTRICAL-PLUMBING-MECHANICAL �Jo 1165 Cedar pring Court •I OWNEP'S PLAN CHECK VALIDATION NAME Gregory Group, Inc. & OTY. ELECTRIC PERMIT FEE Ahmanson Dev. 415HoU5-2100 CONTRACTOR'S NAME OUTLETS-SWITCHES-RECEP 10.00/1.00 regory Group, Inc. Irl.NP-430097 LIGHTING FIXTURES 10.00/1.00 CONTRACTo ADDRESS °nO-C Tw' "DQQ11 h' 8r. RWC ' 94065 �1�5-b9�R��0 APPLIANCES-RESIDENTIAL 4.00 PANELS 10.00 DATE OF APPLICATION! ARCHITECT PLAN CHECK FEE P.C.NO. OR Aram Bassenian, AIA & Assoc. PANELS (OVER 200 AMP) 20.00 ENGINEER UC.NO. C-8395 SIGNS TRANS. 3.00 ARCH.OR ENG. - SOD PERMIT VALIDATION ADDRESS 0 Or I�and Dr. /I1 SPECIAL CIRCUIT Santa An � 5. EH. `199707 rrEMP.METER OR POLE INS. 20.00 1�- APPLICANT'S - MOTORS SEE FEE SCH. P ADDRESS 20-C Twin Dolphin Dr. RWC 94065 SERVICE CHANGE 20.00 p w O o LICENSED CONTRACTORS DECLARATION - 1 - V O�` a U L, P hereby affirm that I am licensed under provisions of Chapter 9' ISSUANCE DATE HA a t- (commencing with Section 7000)of Division 3 of the Business and ��fgggLLL��pGGG ECT. PLG. - MECH. ] Professions Code, d m license is in full force pr�I�sft}�sI 1i 1� 0 �s Z,Z W License Class Lic.Number- (t Ot Dale- Contractor ¢ x f< BUILDING PERMIT ¢ ¢ OWNER-BUILDER DECLARATION a o d 0 MISC.- REFER TO ORD INFORMATION E: ;LL H I hereby collo that I am exempt from the Contractor's License VALUATION $/FT: LL 0 j Law for the following reason(Sec.7031.5,Business and Professions PERMIT ISSUANCE 10.00 fiat Code:Any cityorcounly which requires a permit to construct,Sher, 178,281 IFC ¢O improve,demolish,or repair any structure,prior to its issuance,also ELEC.CONTR. LIC.NO. ELEC. i w m u requires the applicant for such permit to file a signed statement that TOTAL PERMIT TO he is licensed pursuant to the provisions of the Contractor's License - HiQ Law(Chapter 9(commencing with Section 7000)ofDivision 3ofthe SFDI)L i 0 Business and Professions Code)or that he is exempt therefrom and OTY. PLUMBING PERMIT FEE ¢I-$ the basis for the alleged exemption.Any violation of Section 7031.$ STORIES TYPE CONSTR. by anyipplicanthors permit subjects the applicant toacivilpenulty ALTER-DRAIN -WATER IEA.) 5,00 2 SNHR of not more than five hundred dollars(8500).): ❑ 1,as owner of the property,or my employees with wages as - BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not - - intended or offered for sale(Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 R-3 1 Code:The Contractor's License Law does not amply to an owner of - ` property who builds or improves thereon,and who does such work FIXTURES-PER TRAP 5.00 50.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- 2726 mends are not intended or offered for sale.If,however,the building GAS-GAS -11NC.4 OUTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EA.SYSTEM-OVER 4(EA.) 2.00 BUILDING USE builder will have the burden of proving that he did not build or im- \\ prove for purpose of sale.). RES IND CON PB Other ❑ I,as owner of the property,am exclusively contracting with INDUSTRIAL WASTE INTER. 30.00 IN 0 11 licensed contractors to construct the project(Sec. 7044,Business LAWN SPRINKLERS- 1 INC5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code The Contractor's License Law does not apply / to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 -0�- contracts for such projects with a contractons)licensed pursuaril to the Contractor's License Law. TR SEWER-SANITARY-STORM EA.200ft/10.00 c ACT NO. PARCEL NO. ❑ 1 am exempt under Sec. '114P.C.Im INS WATER HEATERW/VENT 6.00 8098 reason Owner Date WATER SYSTEM 5.00 ACC.DATE ACC.FILE NO. WORKERS'COMPENSATION DECLARATION I WATER TREATING EQUIP. 5.00 I hereby affirm that I have a certificate ofeonsent to self-insure, ZONING ENG.SITE N0. or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800.Lab,C.)'Un lted Pacific . Policy No. Company G ❑ Certifredcopyisherebyfurniahed FIRE SPRINK ENERGY T24 Z 2 X Certified copy is filed with the city inspection division. O Applicant MISC.- REFER TO ORD. Y E] NC] -Y Q N[:] ~ LU CERTIFICATE wOF PERMIT ISSUANCE - 10,00 FLOOD ZONE A.L.U.C. EXEMPTION INS FROM WORKERS' W � COMPEENlSAURANCIi PLG.CONTR. LIC.NO. PLG. CL Q (This section need not be completed if the permit is for one TOTAL ❑ N� Y ❑ NE] hundred dollars(5100)outlays.) U O I certify that in the performance of the work hour which this per. OTY. MECHANICAL PERMIT FEE - -FEE SUMMARY U. H mit is issued,1 shall not employ any person in any manner So as to U become Subject to the Workers'Compensation Laws of California. y Date Applicant ALTER OR ADD TO MECH. 5.00 BUILDING 916.0 >_ m NOTICE TO APPLICANT: If,after making this Certificate of Ex__ I.. ? emption,you should become subject to the Workers'Compensation APPLIANCE 5.00 PLAN CHECK 15.5( provisions of the Labor Code, you must forthwith comply with FEE/energy U such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 10MC.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10=C.F.M.) 6.00 SEISMIC FEE 1 hereby affirm that there is a construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 12 52 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Cie.C.j. Security Pacific HEATING UNIT(TO 100,000 B.T.U.) 8.00 Lender's Name - HEATI NG UNIT(OV ER 100,000 B.T.U.)9.50 ELECTRIC - Lender's Address � �� - - I certify that I have read lI apph an!'in'd state 68.581 that(he above VENTILATION FAN (SINGLE) 4.00 information is correct 1 agree to comply with all city and county PLUMBING 68.58 ordinances and state laws relating to building construction, and BOILER-COMP(3 H.P.or 100,000 B.T.U.) 6.00 hereby a flrorim representatives of this city to enter upon the ver BOILER-COMP (O 100,000 BTU)SEE FEE$CH. MECHANICAL above-mentioned property for inspection purposes. 68.58 (We) agree to save, indemnify and keep harmless the City of MISC.- REFER TO ORD. upertino against liabilities,judgments, costs and expenses which CONS Oj may in any way accrue against said City in consequence of the PERMIT ISSUANCE 10.00 Counting of this perml� MECH.CONT. LIC.NO. MECH. TOTAL TOTAL Signature of App[' /Contractor Date OFFICE COPY �� POST THIS CARD NEAR FRONT OF BUILDING PERMIT NUMBER ' + ' CITY OF CUPERTINO I . _ INSPECTION DIVISION JOB INSPECTION RECORD lP�Y�.y PERMIT EXPIRATION , JOB.A`(-+P^�DRESS�c Jb =1�1"'F. JFtV �` UNIT# _LOT# 21 GeAwp PERMIT EXPIRES IF•WORK , owrvER OW / CONTRACTOR e1 C�1 ' A IS NOT STARTED WITHIN.: INSPECTION DATE INSPECTOR INSPECTION RECOFID 180 DAVS'OF PERMIT-:SSU i FOUNDATION - ANCE OR 180 DAYS FROM NOTE: LASTCALLED INSPECTION. ' LIFER ,444 ALL GRADING AND DRAINAGE SHALL BE INSTALLED TO COMPLY WITH THE APPROVED PLANS AND CITY OF. PERMIT VALIDATION 'PREGUNITE CUPERTINO STANDARDS. GARAGE SLABS POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED UNDERGROUND /SLAB PLUMBING ELECTRICAL ISSUANCE DATE'*' MECHANICAL - P BLDG ELECT, PLG. NEC.. Eww� 4 00 NOT POOR FLOOR UNTIL ABOVE HAS BEEN SIGNED 1 `' Qw BUILDING PERMIT - WOOD FLOOR INFORMATION PLUMBING D 11101 ALUATION SIFT. MECHANICAL L'4ty 01 178 281 ELECTRICAL - PERMIT TO - '- FRAMING - SQVII_ INSULATION - STORIES TYPE CONSTR. 2 5hHR OCC.GROUP RES UNITS IIP,.L"ACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED j R-3 1 ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE SO.FT FLOOR ARE TOTAL ACREAGE CONSTRUCTION TAX IS PAID ' DIAPHRAGM THE 2728. ROOF SHEATHING 89 1 RES IND CON BUILDING USE Pe Olt- VL APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALSEl 1:1 DATE INSP. fo E [3 ASSESSORS PARCEL NO ROUGH SAN.N 6 7/A&Z c3 rp PLUMBING 'tQ 00't- ELECT.ENERGY TUBS 8 SHOWER PAN S_ZC_8 PLUMBING ENERGY TRACT NO. PARCEL NO MECHANICAL '� IjLb _ MECH.ENERGY - 8098 1 ELECTRICAL BUILDING ENERGY Acc.DATE ACC FILE NO FRAMING L.t_J`" ELECT.FINAL TEST - < ZONING ENG,SITE NO. :NSU L'A TION - PLUMBING GAS TEST _ GAS MECHANICAL EIRE SPRINK ENERGY T24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING Y ❑ N❑ E] NF EXTERIOR SHEAR - ELECTRICAL RELEASE ' FLOOD20NE INTERIOR SHEAR 8 - FIRE DEPT. - YE] NC] Y L -N❑ SHEETROCK -kQ GRADE FEE SUMMARY EXTERIOR LATH BUILDING BUILDING INTERIOR LATH . T�-}'�y TEMPORARY APPROVALS916 ca SCRATCH COAT - ELECTRIC PLAN CHECK 5.50 GAS NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY I.SEISMIC FEE OCCUPANCY OF BUILDING IS NOT PERMITTED UNTIL BUI LDING FINAL IS SIGNED BY BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC Hw ONE WORKING DAY_BEFORE REQUIRED INSPECTION. PLUMBING z PLEASE GIVE JOB ADDRESS WHEN PHONING. -58 I ' MECHANICAL -SEE PERMIT FOR EXPIRATION DATE'— ca CONST.TAX s o , IMPORTANT! - PLEASE.READ'REVERSE SIDE BEFORE TOTAL CALLING FOR FINAL INSPECTION. OFFICE COPY, 01